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唐雯.脓毒症血流动力学水平对预后有预测价值[J].内科急危重症杂志,2025,31(1):40-44
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| DOI：10.11768/nkjwzzzz20250106 |
| 中文关键词: 脓毒症 无创血流动力学 心脏指数 心输出量 每搏输出量 每搏变异率 预后 |
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| 基金项目:新疆维吾尔自治区自然科学基金（2020D01C096） |
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| 摘要点击次数: 376 |
| 全文下载次数: 536 |
| 中文摘要: |
| 摘要 目的：分析脓毒症患者血流动力学变化，评估其对预后的预测价值。方法：收集135例脓毒症患者的临床资料，根据住院预后分为死亡组32例和生存组103例。比较分析不同时间 [液体复苏前（T0）、液体复苏1、2、4 h（T1、T2、T4）]2组患者无创血流动力学参数 [心脏指数（CI）、心输出量（CO）、每搏输出量（SV）、每搏变异率（SVV）]变化，采用受试者工作特征（ROC）曲线分析各指标对预后的评估价值。结果：T1、T2、T4时刻CI、CO、SV、SVV高于T0时刻，T4时刻低于T2时刻（P均＜0.05）；T1、T2、T4时刻死亡组CI、CO、SV、SVV低于生存组（P均＜0.05）；Logistic回归分析显示，T1、T2、T4时刻CI、CO、SV、SVV是预后相关影响因素（P均＜0.05）；ROC曲线显示，T4时刻CI、CO、SV、SVV联合预测预后的曲线下面积（0.884）最大。结论：无创血流动力学指标CI、CO、SV、SVV可有效预测脓毒症患者预后。 |
| 英文摘要: |
| Abstract Objective: To explore the changes of hemodynamics in patients with sepsis and the prognostic value. Methods: The clinical data of 135 patients with sepsis were collected and the patients were divided into death group (n= 32) and survival group (n= 103) according to the prognosis of hospitalization. The changes of non-invasive hemodynamic parameters \[cardiac index (CI), cardiac output (CO), stroke volume (SV), stroke variation rate (SVV)\] in patients with sepsis were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the prognostic value of CI, CO, SV, SVV before resuscitation (T0), and 1h (T1), 2h (T2) and 4h (T4) after resuscitation. Results: CI, CO, SV and SVV at T1, T2 and T4 were higher than those at T0, and CI, CO, SV, and SVV at T4 were lower than those at T2 (P< 0.05). The CI, CO, SV, and SVV at T1, T2 and T4 in the death group were lower than those in the survival group (P< 0.05). Logistic regression analysis showed that CI, CO, SV, SVV at T1, T2, and T4 were all prognostic related factors (P< 0.05). ROC curve showed that the AUC value of CI, CO, SV, SVV combined to predict prognosis at T4 was the largest, namely 0.884. Conclusions: Non-invasive hemodynamic monitoring indicators (CI, CO, SV, SVV) can effectively predict the prognosis of patients with sepsis. |
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